MEDIX, God. 18 Br. 98/99  •  Pregledni članak  •  Nefrologija HR ENG

Kardiovaskularne bolesti zbog kronične bubrežne bolestiCardiovascular complications of chronic kidney disease

Lidija Orlić, Branka Martinović-Sladoje

Bolesnici već u početnim stadijima kronične bubrežne bolesti (KBB ) i prije razvoja bubrežnoga zatajivanja, imaju znatno povećani rizik za pojavu kardiovaskularne bolesti. Poznato je da 20-godišnji bolesnik na liječenju dijalizom ima jednaki kardiovaskularni rizik kao i osamdesetogodišnjak iz opće populacije. Najčešće kardiovaskularne bolesti u tih bolesnika su hipertrofija lijevoga ventrikula, srčano popuštanje, ishemijska bolest srca, valvularne srčane greške, perikardititisi, aritmije i bolesti perifernih krvnih žila. U patogenezi nastanka kardiovaskularnih bolesti osim tradicionalnih čimbenika dodatni utjecaj imaju i tzv. netradicionalni čimbenici rizika za bolesti srca i krvnih žila, kao što su anemija, upala, malnutricija, poremećaji u metabolizmu kalcija i fosfata, hiperhomocistinemija i poremećaji lipida. Klinička slika ovisit će o tipu kardiovaskularne bolesti. Osnovno u liječenju i prevenciji kardiovaskularnih bolesti u bolesnika s KBB -om jest korekcija anemije, hipertenzije i dislipidemije. 

Ključne riječi:
anemija, dislipidemija, hipertenzija, kronična bubrežna bolest; kardiovaskularna bolest

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 18 Br. 98/99

Patients at the initial stage of chronic kidney disease (CKD), before they develop kidney failure, are at increased risk of developing cardiovascular disease (CVD). It is well-known that 20-year-old dialysis patients have the same cardiovascular risk as do 80-year-old patients in general population. Most frequent CVDs in CKD patients include left ventricular hypertrophy, heart failure, valvular heart disease, pericarditis, cardiac arrhythmias, ischemic heart disease and peripheral vascular disease. In addition to traditional risk factors, non-traditional risk factors associated with CKD also play an important role in the pathogenesis of CVD. They include anaemia, inflammation, malnutrition, abnormal calcium and phosphate metabolism, hyperhomocysteinaemia and lipid disturbance. Clinical symptoms and signs depend on the type of CVD . In patients with CKD, the main treatment and prevention of CVD are correction of anaemia, hypertension and dyslipidaemias. 

Key words:
anemia; cardiovascular diseases; dyslipidemias; hypertension; kidney failure, chronic